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Tick, Tock - It's the time you spend with your kids!

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Parents - You have one of the most important tools in your hands to ensure that your child 
learns to to listen, becomes a competent spoken language communicator and has access 
to a full range of academic, social and occupational choices.

Tick, Tock - check this out.


This is one of the principles of Auditory-Verbal therapy:

Auditory Verbal Therapists,

 "Guide and coach parents to become the primary facilitators of their child’s 
listening and spoken language development through active consistent
participation in individualized Auditory-Verbal Therapy










Ring In The New Year!

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Ring in 2013 with a resolution you can keep.

"I will plan ahead, be creative, spend time talking with my child,
 following his interests,  while expanding his listening abilities,
 learning, vocabulary, spoken language and conversational skills."

Here is some motivation and a fun game to get you started!

Did you know?
For further information contact Dave Sindrey LSLS CertAVT 


Children with normal hearing passively absorb information or "overhear" from the environment and constantly pick up details of information. This is referred to as incidental learning. As much as 90% percent of what a child with typical hearing learns is from overhearing conversations. 

Your child with a hearing loss does not as easily "eavesdrop" and may miss significant information that is not directed at him. As you know, even hearing aids and/or cochlear implants do not restore normal hearing. Children who have a hearing loss need to be taught directly many of the skills, concepts and vocabulary that other children learn incidentally. 


The topic and vocabulary associated with the New Year is a prime example as we usually talk about the New Year once a year which does not result in much repetition for listening, auditory comprehension and processing. In addition, the vocabulary is very specific to the celebration.



Ring in the New Year 

Play this FREE NEW YEARS GAME which will provide fun way to expand new listening and spoken language skills while spending time together as a family. The game creator also included a recipe to make with your child for your New Year celebration. Check out all her ideas at www.speechsnacks.com

Players start at “Baby New Year” and end at “Father Time.” 



 The first set of game cards address New Year vocabulary
and can be used to put words in sentences, give the definition or provide a synonym.
 Talk about how your family celebrates, last years memories and
 throw confetti and stay up until midnight.


These cards contain WH questions and fill-in- the-blanks related to New Year Resolutions. 


Listening and Language: January 2013 Calendar

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LISTEN AND SPOKEN LANGUAGE
2013 CALENDAR


Read to your Kids!

Winter -Listening to Connected Speech

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Listening to Connected Speech 

Winter Card Games

Click HERE for the printable cards.

Snowboarding: A sample winter flashcard.


Before you play:

First print two copies of each set of cards and then paste them on a cardboard backing so that your child can't see through them.   Cut out the individual cards and then you are ready to play various listening activities. 

Some examples on the cards are: 


A person snowboarding.
A person skiing.
Snowflakes falling from the sky.
A woman skating.
People playing hockey.
An icicle hanging from the roof.
A man getting warm by the fire.
A person sledding

1Listen and Match

Spread all the cards on  a table. 
Take turns flipping two cards and saying  the cards that you  flip.

Remember to always look at the card and describe the card BEFORE you show your child the picture. If s/he sees the picture then/he does not need to listen and the hearing opportunity is lost. 

If it's a pair then they keep it and get a point. 

2. Go Snowball (Go Fish)

Deal four or five cards to each player.

Take turns asking the other player if s/he has a card. 'Do you have people playing hockey?' If s/he has it, they must give it to the asking person. asking   If the other person doesn't have it, then you  picks a card from the pile -and say, "Go Snowball".  The person with the most pairs wins. 

3. Target Complex Sentences 

Use the cards as a springboard for elaboration. 

Example are: 

"Do you have the person snowboarding who landed face first in the snow?"

Does anyone have the man and his dog getting warm by the fire after shoveling the driveway?" 


February 2013 Listening and Language Calendar

Groundhog Day Ideas for Auditory-Verbal Therapy

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Groundhog Day Ideas for Auditory-Verbal Therapy

 Click HERE to Visit My Pinterest  Boards








So, You Have A Child With A Hearing Loss On Your Caseload

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So, You Have A Child With A Hearing Loss On Your Caseload

First Steps for Speech Language Pathologists

      
The terms deaf or hard of hearing cover a wide range of conditions and all affect a child’s listening ability and interfere with their language, social and educational development. The number of children in neighborhood preschools and auditory-oral private schools is ever increasing. Many of these students will need support from SLPs to succeed in mainstream classrooms. 
Starting Points 

First, below are facts to stimulate your thinking in order to begin by asking the right questions.

Points to Ponder

• 95% of parents of children with hearing loss are hearing themselves

• The trend is that hearing parents are choosing spoken language options such as Auditory-Verbal Therapy for their children with hearing loss

• Auditory based intervention does not use any visual communication systems

• Children with all degrees of hearing loss can learn spoken language through hearing

• Early diagnosis, aggressive audiological management, contemporary hearing technology is essential

• Audiograms no longer predict outcomes

• Hearing loss is not about the ears? – It’s about the brain! We hear with the brain –the ears are just the way in. (www.Carol Flexer.com)
• Children can have sensori-neural, unilateral, fluctuating, and conductive hearing losses. They wear hearing aids, cochlear and baha implants and/or FM systems.

What is Auditory-Verbal Therapy?


According to The Alexander Graham Academy for Listening and Spoken Language,  “Auditory-Verbal Therapy facilitates optimal acquisition of spoken language through listening by newborns, infants, toddlers, and young children who are deaf or hard of hearing. Auditory-Verbal Therapy promotes early diagnosis, one-on-one therapy, and state-of-the-art audiologic management and technology. Parents and caregivers actively participate in therapy. Through guidance, coaching, and demonstration, parents become the primary facilitators of their child’s spoken language development. Ultimately, parents and caregivers gain confidence that their child can have access to a full range of academic, social, and occupational choices. Auditory-Verbal Therapy must be conducted in adherence to the Principles LSLS of Auditory-Verbal Therapy” (AG Bell Academy, 2012).
Who are Listening and Spoken Language Specialists?


The AG Bell Academy governs the certification of Certified Auditory-Verbal Therapists (LSLSCert. AVT) and the LSLS Certified Auditory-Verbal Educators (LSLS Cert. AVEd).The LSLS certification is awarded to qualified professionals who have met rigorous academic, professional, post-graduate education and mentoring requirements, and have passed a certification exam. Typically, LSLS certified practitioners are licensed audiologists, speech-language pathologists, or educators of the deaf who have the required background, training and experience in listening and spoken language theory and practice with children with hearing loss and their families.

What Do I Need to Know?

Helen Keller once said, “Blindness separates people from things; deafness separates people from people... Without prior experience it is difficult to appreciate the impact hearing has on basic human interaction and daily communication.


If you have the opportunity to see a child who has graduated from AVT or an auditory-oral preschool first and foremost take advantage of theparents’ knowledge. Depend on the audiologist, the AVT’s and the hearing itinerant‘s expertise. In the reference section, there are links to simulations of hearing loss and listening with technology that is insightful. Become familiar with variables that effect hearing such as the impact of noise, distance, room acoustics and equipment malfunctions and ways to manage them. Learn about the child’s listening and learning abilities, social needs, and the IEP accommodations.

Classrooms are auditory – verbal environments where LISTENING serves as the basis for learning. Read this brief children’s story below. Do you recognize it?
You can read the passage but endings are missing and the words are not distinct. It takes time and energy to figure
out the story. This visual simulation is similar to the listening ability of a child with well-fit hearing aids. The small 
font size represents that sound is perceived more quietly than it is for typically hearing
 children. The child may ‘hear’ but not understand what was said because
 pieces are missing. Do you know the story?
Hearing aids and/or cochlear implants do not restore normal hearing. Students who use hearing aids may not be able to hear all of the sounds of speech even when it is quiet and the speaker is close by. A hearing loss is invisible and therefore it is easy to forget the effort required to attend, learn and participate. Children with language delays or additional learning issues make this even more challenging.
Strategies to Facilitate Listening and Spoken Language
There are many specific and purposeful auditory strategies and techniques used to teach a child who is deaf or hard of hearing to learn spoken language through listening. Here are three of the most basic and effective. 
Hearing First!
or
You Will Lose the Opportunity for Listening.

Talk about pictures, objects and events before you show them.
This will focus the child on listening and reduce visual dependence.
After you show the materials, repeat and rephrase the message.
This provides repetition and allows the child to “connect” the
auditory and visual information.


Sit beside the student close to the child’s better ear.


Listening Sandwich


Present information through hearing.
 Add VISUAL cues, as necessary
Then, SAY IT again to promote listening. “Put it back into hearing.”

Wait Time

Pausing and Waiting! 
Allow time for the child to process and attach meaning to what was heard.

Don’t rescue too soon!

In summary, I have included numerous references, important videos, printable handouts and a wealth of resource materials. This will enable you to further investigate opportunities for supporting children with hearing loss and their families.
“I am deaf and I can listen, hear and talk!”
So, you want to learn more?

This first step is to view the TED Talks video, Establishing a Sound Foundation for Children who are Deaf or Hard of Hearing. Dr. Karl R. White explains the differences in raising children with hearing loss today versus 35 years ago and the key factors for successful language development.

Next, watch a series of short videos of my friend and mentor, Carol Flexer, PhD, CCC-A, LSLS Cert. AVT, as she teaches on auditory brain development, acoustic accessibility, the listening environment, signal to noise ratio and more in her engaging videos. Be sure to scroll down to see Carol!
Read a post from the ASHAsphere blog entitled, “Auditory-Verbal Therapy: Supporting Listening and Spoken Language in Young Children with Hearing Loss & Their Families” Todd Houston, Ph.D., CCC-SLP, LSLS Cert. AVT.

Investigate the Listening and Spoken Language Knowledge Center a vast site for children and adults with hearing loss, their families and the professionals who support them.

Spend some time at Success For Kids With Hearing Loss where Karen L. Anderson PhD, an audiologist has a wealth of resources including printable handouts regarding the relationship of types and ranges of hearing loss and the impact on listening and learning, social needs, and the potential school accommodations and therapy needs. Be sure to investigate Learning With a HL - Things For the Teacher To Know and Understand
So if you’re ready to dig in, order your own copy of  101 FAQs about Auditory-Verbal Practice. It is an excellent resource edited by Warren Estabrooks, the President and CEO of WE Listen International. The book takes the reader on a journey through current theory, practice, and evidence-based outcomes. It offers knowledge, guidance, encouragement and hope for future generations of children who are deaf or hard of hearing, their families and professionals. 


MARCH Listening & Spoken Language Calendar

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Click HERE to download your March calendar for the month!


Auditory Verbal Resource Websites and Links

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Where to Begin:

1. TED Talks video, Establishing a Sound Foundation for Children who are Deaf or Hard of Hearing. Dr. Karl R. White explains the differences in raising children with hearing loss today versus 35 years ago and the key factors for successful language development.

2. Series of short videos of my friend and mentor, Carol Flexer, PhD, CCC-A, LSLS Cert. AVT, as she teaches on auditory brain development, acoustic accessibility, the listening environment, signal to noise ratio and more in her engaging videos. Be sure to scroll down to see Carol!

4. Investigate the Listening and Spoken Language Knowledge Center a vast site for children and adults with hearing loss, their families and the professionals who support them.

5.  Success For Kids With Hearing Loss where Karen L. Anderson PhD, an audiologist has a wealth of resources
6. 101 FAQs about Auditory-Verbal Practice. It is an excellent resource edited by Warren Estabrooks, the President and CEO of WE Listen International. The book takes the reader on a journey through current theory, practice, and evidence-based outcomes. It offers knowledge, guidance, encouragement and hope for future generations of children who are deaf or hard of hearing, their families and professionals. 
I want to learn more:  


Audiology and Auditory-Verbal Websites:
Audiology and Speech-Language Pathology Websites:

Therapy Product Websites:
 Special Education Blogs/Websites:

Auditory-Verbal Therapy and Speech-Language Pathology 
Information and Materials Websites:
  • Speaking of Speech
  • Boardmaker Share
  • Super Duper Handy Handouts
  • SLPath
  • Free Technology for Teachers
  • Speech Page
  • Therasimplicity
  • Perkilou Products
  • Sparklebox
  • Classroom Freebies
  • Classroom Freebies Too!
  • Fun Fonix
  • MES English
  • Free Language Stuff
  • Speech-Language Resources
  • Tools For Educators
  • Making Learning Fun
  • Worksheet Works
  • Judith Maginnis Kuster's list of materials that can be adapted for therapy
  • RHL School
  • SEN Teacher
  • School Express
  • Mrs. Pancake
  • Twinkl
  • DLTK
  • Enchanted Learning
  • Kids Pages
  • Super Teacher Worksheets

St. Patrick's Day Activities for Listening and Spoken Language Fun at Home!

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St. Patrick's Day Activities for Listening and Spoken Language Fun at Home! 

Click here: HERE





Don't Talk About Colors!

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St. Patrick's Day for my little listeners today included rainbows.

Did you know that in Auditory-Verbal Therapy we rarely talk about the colors?




Once a child uses the COLOR to describe an object, it becomes the easy,  go to adjective.
 That’s a red apple, a yellow sun, a green frog… Rather, when playing with the frog, we model, expand and talk by describing how the frog hops, has big eyes, can swim in the water etc. 
Have you ever meet a child that is deaf/hh that needs to be TAUGHT colors? 

Humpty Dumpty in Auditory Verbal Therapy

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Activities that involve music, singing and rhyming are natural and enriching for all children,
 and especially for children with cochlear implants/hearing aids who are listening and using spoken language. Incorporate music throughout your  day. Sing songs and act out finger plays.

Click HERE for  printable HUMPTY DUMPTY story props, a minibook and rhyming words.



Acting out HUMPTY DUMPTY with a hard-boiled egg is a fun and learning to listen activity.
 There is a whole lesson in making a Humpty Dumpty egg. 


A few Spoken Language Targets:

For toddlers, focus on "more", "uh-oh", "sit down", "fall down" "broken" talk about the horses and more.

For preschoolers, some concepts to introduce while reading Humpty Dumpty are those, which require fine auditory discrimination involving syntax such as sat/sit, fall/fell, horse/horses/ man/men. 

You may also choose to talk about positional words (e.g. above, below, after, before, over, under, on, off).

Expand your child's vocabulary for broken with synonyms such as - break, separate, split up, fall apart, come apart.

Critical thinking and conversations can emerge while discussing how to repair HUMPTY DUMPTY.

Talk about HUMPTY DUMPTY'S changing emotions throughout the rhyme - happy, frightened, sad, hurt, disappointed.


Check out this free App: Rhymes for Tots by Emantras 
 that also includes putting broken toys together again!



HERE is a easy an experiential listening and language craft that involves making
 HUMPTY DUMPTY out of a yogurt container.



 My friend and colleague Dave Sindrey has  offered a printable Humpty Dumpty Game that your children/students will love. Grab it HERE




Dave Sindrey is a SLP and a Cert. Auditory-Verbal Therapist. 

Dave’s site is http://www.speechtree.ca/. He is the creator of the Listening Room, which provides hundreds of free activities for parents and professionals working with children who have hearing loss.
http://www.hearingjourney.com/Listening_Room/index.cfm?langid=1


Have fun listening and talking. We sure did!







Searching and then Locating Sounds

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GOAL: The child searches for and/or finds the auditory stimulus. 

Searching is a prerequisite skill for localizing.


 Children with hearing in only one ear will not  be able to localize to the sound source.




(I have given this information to parents for many years and don't remember the source or


  if I wrote the protocol. If you know, please contact me!)


Target these localization skills  at home and record your child's skill level:

    a. The skill is not present 
 b. The skill is emerging 
  c. The skill is in process 
d. The skill is acquired


1. searches for loud environmental sounds (vacuum, telephone) or noisemakers (drum, bell) 
__ close (3’)  __ far (10’)   __ another room 
__ inside  __ outside 
__ in quiet  __ noise 
__ prompted  __ spontaneous 
 
2. searches for source of music  
__ close (3’)  __ far (10’)   __ another room 
__ inside  __ outside 
__ in quiet  __ noise 
__ prompted  __ spontaneous 
 
3. searches for source of vocalizations (e.g., exaggerated suprasegmentals) 
__ close (3’)  __ far (10’)   __ another room 
__ inside    __ outside 
__ in quiet    __ noise 
__ prompted    __ spontaneous 
 
4.searches for source of discourse (e.g., connected speech) 
__ close (3’)  __ far (10’)   __ another room 
__ inside  __ outside 
__ in quiet  __ noise 
__ prompted  __ spontaneous 

                                
                                                This is one of my Little Listeners
                                                       who is now in High School!



5. localizes to loud environmental sounds (vacuum, telephone) or noisemakers (drum, bell)  
__ close (3’)  __ far (10’)   __ another room 
__ inside  __ outside 
__ in quiet  __ noise 
__ prompted  __ spontaneous 
__ one level  __ multiple levels 

6. localizes to music source  
__ close (3’)  __ far (10’)   __ another room 
__ inside  __ outside 
__ in quiet  __ noise 
__ prompted  __ spontaneous 
__ one level  __ multiple levels 

7. localizes to speaker making vocalizations  
(e.g., exaggerated suprasegmentals) 
__ close (3’)  __ far (10’)  __ another room 
__ inside  __ outside 
__ in quiet  __ noise 
__ prompted  __ spontaneous 

8. localizes to speaker using discourse  
__ close (3’)  __ far (10’)   __ another room 
__ inside  __ outside 
__ in quiet  __ noise 
__ prompted  __ spontaneous 
__ one level  __ multiple levels

 

Sound Localization: Easter Egg Hunt

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Sound Localization and the 
Electronic Easter Egg Hunt



Available to purchase: JoJo & Friends Electronic Easter Egg Hunt by Ouaps Company


Hide one of the egg noise-making toys, from your child’s view somewhere in a room.

When beginning the Egg Hunt:

First, ask your child WHAT he hears.

Then, WHERE the sound is coming from.

You may want to begin by keeping the choices simple. For example,
"Do you hear the sound near the windows or closer to the fireplace?"
Remind the child to listen first or else they will begin searching with their eyes! 



To play this game, with the electronic Eggs, press the on/off button on the side and hide it.
The egg then calls out phrases periodically like, "Yoo-hoo! I'm hiding! I'm over here! " 
Once the toy is found, you can pop it apart to reveal the character inside,
 who will exclaim something like, "It's me, Maggie! You found me!

Sound Localization

The ability to localize sounds develops over time. The earlier your child has received his bilateral cochlear implants/hearing aids, the sooner he starts picking up sound cues and gains valuable experiences localizing sounds. 



Tips For Children Learning to Locate Sound Sources

  • Using two different musical toys, hidden from the child’s view, locating one to the left of the child and one to the right side of the child. Then, make a sound with each instrument in varied sequence, ask your child to identify which instrument is on which side. You can do this with Mom's vs. Dad's voice as well. 
  • At the dinner table or while playing games help your child locate who is speaking. Your entire family can help the child learn to locate and follow then natural flow of
  • conversation.
  • Playing hide-and-seek indoors (e.g. room or house), hiding yourself and calling out to your child to find you. This task may be varied by taking turns between hiding and searching.
  • Games in a group, such as “Blindman’s Buff ” or “I Spy” (with sounds), hand clapping games are ideal for practicing sound localization in a  playful way.
  • Teach your child that is hard of hearing to be extra alert visually in crowds, walking near cars, crossing streets, riding bicycles, and in group games. Remind your child to look for traffic and not to depend on hearing oncoming vehicles. If your child rides a bicycle, consider rear-view mirrors to help him see traffic he might not hear.

Sample Localization GOAL with Benchmarks

GOAL: Child will auditory locate with bilateral cochlear implants/hearing aids:

-  a sound presented at ear level within a 3 foot radius in front or on either side
-  a sound presented at ear level within a 6 foot radius from behind
 - understand and verify gross, environmental, music or speech sounds within  9 feet, then 12 feet and  finally, within the same room in all directions.
 - Understand sounds with a specific location or direction outside.

Click HERE for a packet by Med-EL entitled,
 "Sound Localization Tips and Information for users of Cochlear Implants"








APRIL Listening & Spoken Language Calendar

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                     Click HERE to download your own printable copy of the Listening Calendar for April.


                                

Pointing Out Common Sounds To Your Little Listener

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Some Common Sounds

If you have typical hearing, you probably tend to overlook many sounds in your everyday living environment. You probably don’t think about the click of a light switch, whir of the ceiling fan, or the bang of something being dropped. Children with hearing loss need to learn about these many sounds that are part of the everyday world. This list of common sounds will give you ideas about what to point out to your child as you help him develop his listening skills. 

Grab your own copy of this handout from the John Tracy Clinic HERE.



Keep Talking: Before & After Implant Process

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Keep on Talking: Pre & Post Ci Process

Reprinted from the Chatterbox Blog

Grab your copy of this post from the John Tracy Clinic HERE.
You have made the decision to provide your child with a cochlear implant. You might be wondering about what you can do before the surgery, while you wait for activation and after the first mapping. Here are simple suggestions your family can consider. Your child’s speech therapist and cochlear implant team will also have suggestions about the many ways you can provide audition and language.
What can I do before my child receives the implant?
You want your little one to benefit from his implant from the moment of activation. And that means he must be prepared. Even when you are unsure of what he hears with hearing aids, there is still much you can do.
  • Talk near the microphone of his hearing aids when you are looking at a book together, playing on the floor with his favorite toys, cuddling or enjoying any family activity. Just take a minute to lean close to your child’s hearing aid when you talk.
  • Sing, sing, sing! Sing about picking up toys. Sing about going to bed. Sing children’s songs. Hold your child in your arms, sway to the rhythm of your song and be close to his hearing aids. You may be unsure of what he hears, but he might perceive some bit of rhythm. This will be very important in the development of spoken language skills.
  • Vocal play! Use your voice in a playful manner. Say, “Up, up, up, dooooowwwn” as you lift your child and place him into a chair or “Hellooooo,” as you enter the house.
  • Provide lots of play, reading and daily experiences to help your child learn. Language is a part of all that you do and your child will gain new words, ideas and knowledge as you fill his day with many conversations and activities. He can learn much from the enjoyable stimulation his family provides during this time.
What should I do between surgery and the time of activation?

During the time that your child has a bandage, he might not be able to wear his hearing aid on the non-implanted ear. And if he has received simultaneous bilateral implants, he will not be able to hear you before the implant is activated. But you can still communicate. Since social interaction is basic to communication, you can encourage eye contact and smiles as well as pointing and gestures. If you know sign language, use it now!
Get down to your child’s level and provide language, “You want water? OK, Mommy will get some water for you.” If he can’t hear your voice, get up and go to him. Show him a sandwich and ask if he is ready for lunch. Visual clues are important now, so give your little one every opportunity to connect what he sees with what you are saying. And, expect “turn taking” in your conversations.
If your child is receiving one implant, he can wear his hearing aid on the non-implanted ear while waiting for the initial stimulation. However with only one hearing aid, your little one will not be able to localize the direction of a sound because all sounds will be heard from the side with the hearing aid. He will not hear as well in noise, such as in the car or if the TV is on. And in general, his under•standing of sound could be diminished. When you can, speak close to the microphone of the hearing aid, and use some visual techniques, too.
What can I expect at the time of activation?

Your cochlear implant team will explain the initial activation process. Some children do not react, while others smile or become fearful. Naturally you do not want your little one to be afraid of the sounds he hears, but his response does indicate that he is hearing and that is important.
If your child receives a second implant a few months after the first, you can expect him to be more comfortable with the mapping session, however it will take time for him to become accustomed to hearing with the new implant.
What can I expect after activation?

You have to repeat what was done when your child first received his hearing aids. If your little one has experienced vocal play and if there was an auditory connection to sound, he will connect to the sounds he hears with the implant. This is why the pre-implant time is so important.
  1. Go back to vocal play and singing. Have fun with various sounds. The cow says, “Mooooo.” The kitty says “Meow!” Fly toy airplanes while you say, “wheeeee.” Think of some simple children’s songs and sing them every day.
  2. Help your child recognize and understand environmental sounds such as the telephone, microwave, keys, cars and trains. Ask a friend to knock on the door or ring the door bell. Take your child to the door as you say, “Listen. That’s the doorbell. Let’s see who is at the door.” Listen to the washing machine together and then look at the clothes inside. Help your child understand that sounds have meaning.
  3. Draw his attention to voices, too. “Grandpa is calling you. Listen.” He should begin to respond to voices quickly, so talk, talk, talk! And help him learn his name, too. Use your little one’s name when you talk to him. “Who are you? You are Raúl. Raúl.” Point to him as you talk. “Who am I? I’m Mommy.” Point to yourself.
Initially your child may show a lot of response to voices and environmental sounds. Then a plateau may occur while his brain is developing the ability to use the implant. Learning to listen and under•stand takes time and practice. Be patient and keep talking.

Article 6

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Early Expectations for a Child with a Cochlear Implant

Reprinted from the Chatterbox Blog.
Grab your copy of this post from the John Tracy Clinic HERE.

Families often have many emotions about their child’s cochlear implant (CI). One common feeling is of uncertainty. Parents are unsure of what changes they will see and when their child might talk. Surgery and being fitted with external equipment begins the process. The first use of the activated implant is awareness of sounds. Family members can be very involved in helping a child develop a range of listening skills. As a child increases his listening and understanding, his speech skills can expand.
Mapping
The sounds transmitted through a CI are not the same as those heard with a hearing aid. A child’s brain needs practice recognizing these new sensations as sound. How quickly a child uses his CI depends on many factors including when he was deafened, when the loss was diagnosed, the time between diagnosis and implantation, the amount of hearing provided by hearing aids and the cause of the hearing loss. All these factors and more impact a child’s recognition and understanding of new sounds.
After implant surgery there are several follow-up appointments to program or MAP it. When the CI is first activated a child might become very quiet or his vocalizations may increase. He may not yet be attentive to other voices or sounds. These varied beginning responses are a natural part of the listening process but parents often worry that the implant is not working. Learning to listen takes time and the family can feel assured that few or no responses can be typical at the start.
After the initial mapping is complete, most children visit their audiologist every 3-4 months. The audiologist can suggest expectations for the child’s responses. Families, teachers and therapists can help document their observations of how the child is meeting those expectations. Parents can also request additional appointments at any time if their child’s responses change unexpectedly.

Listening

A child with a CI discovers and uses sound through the same developmental steps as a child with typical hearing. During the first three months after the implant is activated, parents may notice spontaneous reactions when certain sounds are heard. A child might look up or startle slightly.  Then the child may begin to search for the sound as he looks in the direction of what he hears. 
A child learns to listen from parents talking, singing and pointing out sounds. Parents might use “bye, bye” “uh oh” and other sing-song words in addition to typical speech. Sounds from the microwave, musical toys, water running or an airplane overhead are examples of natural events that can be part of early listening. A family’s enthusiasm and interest in sounds can encourage a child to be aware and become excited about many sounds around him.
The developmental stages for listening are detection, discrimination, identification and comprehension.
Detection
The first level of listening is an increasing awareness of sound. A child might now show interest or reactions to an increasing amount of sounds. Parents can call attention to different sounds and search with their child for sound sources to encourage increased "detection".
Discrimination
The next level of auditory development is noticing differences between sounds. A child now might repeat "mmmm" after someone says "yummmm". He does not yet understand the meaning of sound but he is able to "discriminate" between sounds.
Identification
Identification involves making associations with sounds.  A child now might look toward the door when knocking occurs.  He may not yet know that the sound indicates Grandpa is at the door but he is able to “identify” the source of the sound.
Comprehension
Understanding what is heard is a more complex skill developed after detection, discrimination and identification. A child now shows he knows the meaning of some sounds or words.  If he gets the shoes when asked to do so and tries to put them on, he “comprehended” what was said!
As a child advances through these stages, families can create multiple listening opportunities throughout the day.  Parents can use many ways to help a child become a better listener.  Suggestions appropriate for babies and preschoolers include:
  1. Play together and talk in play. Use words, make sounds for motions and invent noises for toys.
  2. Enjoy songs, rhymes and acting out familiar verses.  Encourage him to participate with you.
  3. Read books. Use voice inflection and demonstrate many levels of speech and types of sounds.
  4. Talk about what he is doing.  When he is watching you, describe what you are doing too.
  5. Listen and move to music.  Explore turning on and off toys and objects that make sounds.
  6. Point out sounds occurring both indoors and outdoors and especially for things he enjoys.
  7. Pause first to give your child time to think about and then react to sounds and speech.

Talking

Early expectations for a child with an implant include increased attention, listening and communication. A child’s hearing or CI age can be measured in weeks and months.  With much daily experience, special services and ongoing support, the goal is for a child’s listening skills to eventually match his chronological age. Together with their speech and hearing team, parents can guide their child through systematic and successful experiences first in listening and then in speech. Learning to be a listener is complex skill and the first fun step using a CI!  Then comes talking!

Earth Day Activities for Listening and Spoken Language Fun at Home!

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Earth Day Activities for Listening and Spoken Language Fun at Home! 





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